Clipper F. Young, PharmD

Generations of pharmacists had been taught that we are drug experts, and we still are in today’s healthcare systems. But we are also becoming more involved and active in health promotion, health education, disease prevention, and disease management.
	One of the major areas in which we are becoming more involved is diabetes care. Since July 2015, as a clinical pharmacist, I have been a member of an interdisciplinary diabetes team, the DREAM (Diabetes Research Education and Management) Team, at Touro University California College of Osteopathic Medicine in Vallejo.
	Our team takes an interprofessional approach to tackle diabetes our area, from conducting clinical trials and educating healthcare students and practicing clinicians, to leading community outreach efforts in diabetes prevention and providing comprehensive diabetes consultations and clinical care.
	In providing comprehensive diabetes clinical care to patients, I:

Offer medication therapy management focusing on diabetes and cardiovascular risk reduction;

Choose the most clinically sound and appropriate antidiabetic agents with the team;

Offer education on pen devices during the initial visit, discuss a treatment plan for each consultation, titrate medications, and offer insulin pump education and support.

The two diabetologists feel their treatment plans for patients are more complete with a clinical pharmacist on the team. Discussions that lead to treatment plans reflect what the pharmacy profession is trying to achieve: optimizing the safe and effective use of medications.
	Touro University California has created and created a community-based outreach program, Mobile Diabetes Education Center (MOBEC). I serve as program evaluator and have developed a needs assessment and a mechanism to collect, analyze, and interpret data. A registered dietitian and I have been leading efforts to create a series of five-minute, mini-diabetes self-care management modules using the American Association of Diabetes Educators (AADE) 7 Self-Care Behaviors as its backbone.
	Diabetes is not the only area where pharmacists have expanded roles. Other settings of care include:

The acute care setting in hospitals, where clinical pharmacists round with the healthcare team to provide drug recommendations;

Skilled nursing facilities and long-term care facilities, to monitor medication regimens;

Poison control centers, to handle potentially life-threatening medication overdose situations;

Outpatient disease management services settings, where pharmacists work in an interprofessional chronic care model, etc.

Those expansions require additional training and/or education beyond a Doctor of Pharmacy degree, leading to an emphasis on postgraduate education, residency/fellowship training, and board certifications. More pharmacists are now being trained and working in healthcare systems, academic institutions, and governmental entities, which have provided us with opportunities to expand our practice capacity as integral members in healthcare.
	Pharmacy practices include research pharmacists in pharmacy informatics who analyze data and patterns in healthcare systems, and public health pharmacists who help tackle public health issues such as diabetes, smoking cessation, and HIV prevention and treatment.
	The roles of pharmacists in the healthcare sector have changed tremendously with patients’ needs at the heart of our daily practices. One core principle remains constant: It is the pharmacist’s passion and duty to optimize the safe and effective use of medications and improve the health of the society.

Articles

One pharmacist’s thoughts on how and why the practicing pharmacist is becoming a holistic health advocate, as opposed to merely an encyclopedia of pharmaceuticals.